The prevalence and control of soil-transmitted nematode infections among children and women in the plantations in Sri Lanka.

OBJECTIVE: To determine the prevalence of soil-transmitted nematode infections among children and to assess the magnitude of nematode infections among women in the reproductive age group. DESIGN: Cross-sectional study. SETTING: 14 government owned plantations in the up-country and low-country regions of Sri Lanka. SUBJECTS: 1614 children 3 to 12 years of age and 246 women 18 to 44 years selected using a multi-stage random sampling technique. MEASUREMENTS: Egg count from stool samples collected from subjects using the quantitative Kato-Katz technique; percentage of children and women infected. RESULTS: 89.7% of the children and 86.2% of the women had at least one type of soil-transmitted nematode infection. Ascaris lumbricoides was the most common infection (77.0% of the children and 69.5% of the women). 69.4% of the children and 56.5% of the women had Trichuris trichiura infection and 23.2% of the children and 41.4% of the women had hookworm infection. Hookworm infection was much more common in the low country plantations. CONCLUSION: The high prevalence rates reflect widespread faecal contamination of the environment in the plantations due to poor and congested housing conditions and insufficient sanitary facilities. As the physical environment is not likely to change in the short term, the strategy for control of soil-transmitted nematode infections should focus on regular deworming of children and health education. A control program based on these principles was initiated in the estate sector after this study was completed.